Troponin T in COVID-19 hospitalized patients: Kinetics matter

Background: Coronavirus disease 2019 (COVID-19) emerged as a worldwide health crisis, over-whelming healthcare systems. Elevated cardiac troponin T (cTn T) at admission was associated with increased in-hospital mortality. However, data addressing the role of cTn T in major adverse cardiovas-cular events (MACE) in COVID-19 are scarce. Therefore, we assessed the role of baseline cTn T and cTn T kinetics for MACE and in-hospital mortality prediction in COVID-19. Methods: Three hundred and ten patients were included prospectively. One hundred and eight patients were excluded due to incomplete records. Patients were divided into three groups according to cTn T kinetics: ascending, descending, and constant. The cTn T slope was defined as the ratio of the cTn T change over time. The primary and secondary endpoints were MACE and in-hospital mortality. Results: Two hundred and two patients were included in the analysis (mean age 64.4 +/- 16.7 years, 119 [58.9%] males). Mean duration of hospitalization was 14.0 +/- 12.3 days. Sixty (29.7%) patients had MACE, and 40 (19.8%) patients died. Baseline cTn T predicted both endpoints (p = 0.047, hazard ratio [HR] 1.805, 95% confidence interval [CI] 1.009-3.231; p = 0.009, HR 2.322, 95% CI 1.234-4.369). Increased cTn T slope predicted mortality (p = 0.041, HR 1.006, 95% CI 1.000-1.011). Constant cTn T was associated with lower MACE and mortality (p = 0.000, HR 3.080, 95% CI 1.914-4.954, p = 0.000, HR 2.851, 95% CI 1.828-4.447). Conclusions: The present study emphasizes the additional role of cTn T testing in COVID-19 pa-tients for risk stratification and improved diagnostic pathway and management. (Cardiol J 2021; 28, 6: 807-815)